A 61-year-old woman was transferred to the medicine service with confusion.
Seven months earlier she developed right upper quadrant abdominal pain. Computed tomography showed numerous small gall stones but also revealed extensive ascites. She underwent laparoscopic cholecystectomy and aspiration of peritoneal fluid. Cytopathology revealed ovarian carcinoma, with tumor deposits on the serosal surface of the gallbladder, peritoneum, and omentum. Malignant cells were positive for PAX8 and WTI, and negative for CD56 and p53. She also developed a malignant right pleural effusion.
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-Beatriz Wills, MDa,b, Qihua Fan, MDa,b,c, Caitlin Alexander, MDd, Christopher R. Bailey, MDa,b,e, Allan C. Gelber, MDa,b,
This article originally appeared in the July 2019 issue of The American Journal of Medicine.